Anxiety In Children Part II.
The Teen Years

Adolescent Anxiety: Is It The New Norm?

Guest post by Michele Mannering, PhD, Psychologist 🧠 Mom 😘 Runner 🏃‍♀️

Researchers suggests that at some point, 30% of children and adolescents will meet criteria for an anxiety disorder, but the majority (80%) of these kids never get help.  This is a pretty high statistic, but especially worrisome when we consider that untreated anxiety increases the risk for things such as substance abuse, suicidality, and depression. (Koplewicz & Salcedo 2018). 

In any adolescent psychology textbook, you will find discussion of the imaginary audience. It’s an occurrence that most adolescents go through- feeling like all eyes are on you all the time and that everyone knows what you are doing.  Did whoever coined that phrase have any inkling that the imaginary audience would morph into a real audience by 2020? Adolescents are under a microscope: parents, teachers, coaches, and all of the viewers in the abyss known as social media.  If adolescents are seemingly “on” and being judged all the time, is it any wonder we are seeing rates of anxiety skyrocket (researchers report a 17% increase in incidence over the last decade)? Knowing what we know, how do parents and other adults working with adolescents recognize when there are concerns around anxiety? 

Here are some of the common forms of anxiety experienced by adolescents (this is not a comprehensive list):

Generalized Anxiety

Most parents complain that their adolescent has checked out and that they rely on friends instead of parents for advice and feedback.  What about the adolescent who is still tuned in, though, and bombards their parents with “what if” questions and hypothetical scenarios? Concerns about health, the future, and other aspects of life that are unknown should not be dominant thoughts in the adolescent brain.  What if your adolescent still needs reassurance about things, even after you have provided reassurance a million times before? Do you hear things like “are you sure” or “can you promise me”?  These are all red flags of generalized anxiety.  Adolescents are trying to control all that is out of control by seeking reassurance from parents.

Social Anxiety

It is developmentally appropriate for adolescents to care about what others think of them, but social anxiety involves a worry about being judged or embarrassed that is above and beyond what peers commonly experience.  If there is a decrease in the amount of time your teen wants to spend with friends or participating in group activities, take note.  

Separation Anxiety

We tend to think of separation anxiety as the kid latched on to a parents’ leg petrified to go into preschool.  Separation anxiety impacts teens as well.  Does your teen have a hard time when you travel or are away from them? Do they avoid parties, sleepovers or other activities that will keep them away from you? When you are away, do they frequently check in to make sure you are OK? Do they report an increase in physical symptoms such as a headache or gastrointestinal distress before you are scheduled to go somewhere? Some adolescents do like spending time with their parents, despite clichés otherwise, but it is important to notice if their staying by your side may be fear based instead.  

Academic and Performance Anxiety

Most parents notice quickly when there is a drastic change in their child’s school grades.  Back in the late 1970’s, Steven Berglas and Edward Jones coined the phrase “self-handicapping strategy”.  Could it be that the adolescent’s grades have shifted because of this idea? Basically, when anxious, some adopt this mentality: if I don’t try, then failure will hurt less.  And, if I don’t try but still succeed, then that is a bonus.  So while it may seem counterintuitive for a teen that is already thinking about college, this happens ALL. THE. TIME.  A zero on an assignment that is not turned in hurts less than a C on an assignment you tried really hard on.  The same phenomenon can extend into athletics and other extra curricular activities where performance and judgment are involved.

Agoraphobia

This one can be a little tricky and overlap with some of the other anxieties discussed.  Your adolescent may avoid places such as movie theaters, school, the subway, shopping mall or sports arenas.  The issue isn’t a fear of crowds, but instead the fear is based in worry of being unable to escape or fear of embarrassment.  Anecdotally, feelings of needing an exit and not wanting to be trapped have escalated as a result of attacks happening in everyday places such as movie theaters and concerts.  

Additional Notes

With any subtype of anxiety, there may be physical symptoms.  If your adolescent begins to complain of anything physical, you obviously want to rule out that there is a physiological root.  If your teen is declared medically sound, don’t be surprised if the following may be anxiety manifesting: headaches, stomachaches, fatigue, sweating, hyperventilation, insomnia, body aches, and easily startling.  Further, anxiety in adolescents can be hard to identify because of inconsistent presentation.  For some, there are signs similar to those seen in younger children: becoming oppositional, argumentative, etc.  For others, there is internalization: seeming more distant and withdrawn.  Hence the fight or flight phenomenon: some externalize and act while others internalize and retreat.  Another common symptom reported by teens is an inability to pay attention and frequent distraction.

Final Thoughts

While getting older is no fun, the idea of going back to the adolescent years can be terrifying.  Thinking about these realities can certainly seem grim.  The truth is this generation of teens is up against a series of stressors that has been unknown to previous generations.  Professionals are continuing to learn about the real impact of social media, instant access to (always terrible) news, and living in a world that often feels unsafe.

One of the most difficult parts for parents is teasing apart what is what is normal anxiety and what warrants consultation with a professional.  We actually want teenagers to have some anxieties.  And when typical worries and fears pop up, our job as adults is to allow teens to work through.  Shielding teens from worry, fear and anxiety actually opens a whole other can of worms.  Adolescents need to be able to cope with negative feelings and adversity.  Without practice coping, their resilience down the road will be stunted.  However, a parent’s gut instinct is generally right.  If you feel that there is more going on and that your teen’s quality of life is impacted, it’s likely time to seek help.  Your family doctor can help direct you to psychiatrists and therapists (trained in Cognitive Behavioral Therapy) verse in treatment of anxiety disorders. 

We can’t change the pace at which things are changing and the realities that teens are exposed to.  We can, however, be aware of early warning signs teens may be exhibiting and intervene accordingly.    


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